This application is an improvement on applicant""s U.S. Pat. No. 5,688,230 filed Apr. 5, 1995 and U.S. Pat. No. 5,817,121 filed on Oct. 6, 1998.
There are no statements regarding Federally-sponsored research or developments.
1. Field of the Invention
This invention comprises a new and improved instrument for dissecting, separating, wiping or cleaning tissues during the performance of endoscopic surgery.
2. Description of the Related Art Including Information Disclosed Under 37 CFR xc2xa7xc2xa71.97-1.98.
The number of laparoscopic procedures is steadily increasing as more and more surgeons are becoming accustomed to the endoscopic modality of operating. Indeed, numerous new instruments and devices have been introduced and are being used to facilitate the performance of endoscopic operations. With the broadening spectrum of procedures being performed, there is increased demand for more specialized instruments. In response to this demand, the present invention discloses a new specialized instrument for dissecting tissues during endoscopic surgery which is a variation on the Christoudias endodissector disclosed in U.S. Pat. No. 5,817,121.
In the prior art, an instrument with similar functions has been used extensively in conventional surgery and is known as a xe2x80x9cpeanutxe2x80x9d and/or xe2x80x9cdissector.xe2x80x9d This xe2x80x9cpeanutxe2x80x9d or xe2x80x9cdissectorxe2x80x9d is comprised of mesh gauze shaped in the form of a ball which is marketed as xe2x80x9cweck-sorbxe2x80x9d or xe2x80x9cpilling weck.xe2x80x9d
This ball shaped mesh gauze is grasped firmly by the end portions or tip of any commonly used surgical clamp such as a xe2x80x9cKelly Clamp,xe2x80x9d xe2x80x9ctonsil clamp,xe2x80x9d xe2x80x9chemostat,xe2x80x9d etc. and by manipulating the clamp, the ball shaped mesh gauze is used for dissection, cleaning, sponging and/or wiping the target tissues. While this xe2x80x9cdissectorxe2x80x9d is suitable for conventional surgery, it cannot be used in laparoscopic surgery since there is a limit on the dimensions of the instrument with the mesh gauze ball that can pass through a standard endoscopic port. This precludes the use of conventional surgical instruments for these purposes. On the other hand, the use of the laparoscopic graspers currently available for these functions are both difficult to use and often dangerous. The graspers are difficult to use because the grasping surface is neither suitable nor strong enough to close firmly on the gauze ball thus leaving the jaws partially open and therefore generally too bulky to go through the port. If the laparoscopic grasper with the gauze ball did go through the port, it is possible that due to the imperfect grasp, the mesh gauze ball could escape from the instrument and become lost in the abdomen. Endless amounts of time would then have to be consumed to find and retrieve the mesh ball to avoid life threatening consequences.
A disposable laparoscopic xe2x80x9cpeanutxe2x80x9d manufactured by U.S. Surgical under the name of Endopeanut consists of a long stem having a piece of mesh gauze rolled and fixed in place over one end. The functioning gauze end is cylindrical and is lacking in strength and uniformity; it is not nearly as strong and easy to manipulate as the open conventional surgery xe2x80x9cpeanutxe2x80x9d or xe2x80x9cdissector.xe2x80x9d
There are significant differences between the Christoudias Endodissector and the Dodson xe2x80x9cIrrigator-Aspirator, Blunt Dissectorxe2x80x9d disclosed in U.S. Pat. No. 5,205,816. Dodson describes xe2x80x9cA laparoscopic medical instrument for performing blunt dissection as well as irrigator and aspirator.xe2x80x9d It is obvious that the Dodson instrument has no working port through which a cautery electrode, scissors or grasper can be inserted and used as described by the applicant in Claims 4 and 5.
A significant difference is that the Dodson instrument has no working port. It is specifically stated that the function of his instrument, (column 1, lines 9, 10, 100) is an irrigator aspirator and blunt dissector. There is no reference or description in Dodson""s text, drawings or claims that show any intent or feature that will allow the use of any laparoscopic instrument through the lumen of his irrigator, aspirator, or blunt dissector. In the summary of his invention, Dodson describes the use of a Luer fitting which is press fit over the proximal end of his instrument connecting it to suction and irrigation. No laparoscopic instrument currently in use can fit through a Luer lock that is currently used in a standard operating room.
The present invention is intended to fill this void by providing an endoscopic instrument of the type disclosed in FIGS. 10, 11a, 16, 17, 22c and 23 in U.S. Pat. No. 5,817,121. This instrument is manufactured to incorporate at its working end, which is located at the end of the instrument opposite the handle, a tip made of molded plastic mesh gauze. This invention includes an alternate disposable solid instrument and an alternate disposable tubular instrument which will incorporate the mesh plastic tip by molding such mesh plastic onto the working end of the instrument opposite the handle end of the instrument for use in both laparoscopic and conventional surgery.
The instrument is composed of one or more components which assembled comprise an elongated solid or tubular instrument which can accommodate a one piece, molded, solid or tubular plastic mesh tip. This invention involves a variation of the Christoudias endodissector for dissecting, wiping, or cleaning tissues during endoscopic surgery. The instrument basically includes a head comprising mounting means at one end, an elongated body and a handle at the other end. The instrument includes a mesh plastic body which is mounted securely on the head end portion of the instrument threads or other mounting means.
Accordingly, an object of this invention is to provide a new and improved plastic mesh dissector for endoscopic and/or conventional surgery.
Another object of this invention is to provide a new and improved dissector instrument which is an improvement on the dissector disclosed in U.S. Pat. No. 5,817,121.